Individual provider · NPI-1

Jesse Chavez, ATC, LAT

Specialist/Technologist, Athletic Trainer · Oklahoma City, OK

NPI number1003225863
StatusActive
Last updated in NPPESAug 6, 2014

Details

NPI
1003225863
Entity type
Individual (NPI-1)
Name
Jesse Chavez
Credential
ATC, LAT
Sex
Male
Sole proprietor
Yes
Enumeration date
Aug 6, 2014
Last updated
Aug 6, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
2255A2300X Specialist/Technologist, Athletic Trainer722OKYes

Practice location

2501 N Blackwelder Ave
Oklahoma City, OK 73106-1402

Phone 405-208-6500

Mailing address

2601 N Kentucky Ave Apt 413
Oklahoma City, OK 73106-1282

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